Challenges of Tuberculosis in Iran

Background: Despite the implementation of the national control program, tuberculosis is one of the greatest health problems in Iran. The prevalence of different strains in specific ethnic populations suggests that Mycobacterium tuberculosis transmission has been limited and restricted to close contact. Objectives: In the present review, we describe the epidemiology of tuberculosis in Iran. Methods: In this review article, databases including Scopus, PubMed, and Google scholar were used to search for the epidemiology of tuberculosis in Iran. Results: Since 1996, tuberculosis incidence has been decreased as the national tuberculosis control program was established in Iran. However, due to the emergence of drug-resistant strains, recurrence of the disease, and association of tuberculosis with HIV pandemic, tuberculosis is becoming a health problem in Iran like many other parts of the world. Moreover, several other factors such as poverty, homelessness, inadequate access to health services, and lack of infrastructure in public health play an important role in worsening the situation. The distribution of the disease is not similar in all parts of Iran and it is higher in the western and eastern parts than the central areas. Conclusions: Review of the studies revealed that levels of multidrug-resistant tuberculosis among new tuberculosis patients are increasing in Iran and the vaccination system needs to be reformed. Because of the increasing number of patients coming from neighboring countries with multidrug-resistant tuberculosis, this area needs more stewardship and control in order to prevent the outbreak of multidrug-resistant tuberculosis. Finally, by improving the healthcare system, it is trusted that a more noteworthy number of these patients will be cured in Iran.